


After Anna

by paraboobizarre



Category: The Following
Genre: Children, Gen, Sad
Language: English
Status: Completed
Published: 2013-04-28
Updated: 2013-04-28
Packaged: 2017-12-09 20:23:54
Rating: Mature
Warnings: Creator Chose Not To Use Archive Warnings
Chapters: 1
Words: 2,268
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/777633
Author URL: https://archiveofourown.org/users/paraboobizarre/pseuds/paraboobizarre
Summary: <blockquote class="userstuff">
              <p>The story of why Jacob quit medical school.</p><p> </p><p>Trouble's name was Anna. And after Anna there was no going back.</p>
            </blockquote>





	After Anna

**Author's Note:**

> Potential trigger warning: Child death due to illness

He never told his dad why he dropped out of medical school. He wouldn't understand. Worse even, his father would have looked at him the way he always did. _I can't believe you are my son, get a grip on yourself, do you know how disappointed I am with you right now_ , all swimming in that pale grey, piercing gaze and he just couldn't.

Medical school had always been his dad's dream, never his, but still he had gone. Playing the good son had become so second nature to him, he didn't even question his father's plans for his future. Everything had been okay, kind of fun even. He had been good in school, contrary to his expectations, it had even been interesting and he had managed not throw up or faint during gross anatomy lab. It was in his second year that trouble found him.

Trouble's name was Anna. And after Anna there was no going back.

Anna was ten years old and Jacob met her in his second week at the hospital.  
Anna had cancer. ALL, acute lymphoblastic leukemia, it said so on her chart. She's a statistical outlier, the treating physician told the group of medical students as they were hunched over copies of Anna's chart in a poorly ventilated conference room. ALL typically peaks at two to five years of age and then later again after 65.  
ALL is very treatable. Normally. About 94% of cases are cured. Normally. Not this one though. 

Paper rustled as fifteen people flipped through fifteen folders to the lab results. There was a low whistle a few chairs to the left. Renal function down the toilet, thrombos gone the way of the dodo. It had spread to her lungs and brain.

Five days, give or take. The doctor closed the folder, tossed it on the heap of already discussed cases and took a sip of his coffee before picking up the next file.  
“Mills, Howard. Emphysema.”

At the end of the day, Jacob can't find his car keys. He looks for them everywhere, emptying out his duffel bag and turning all his pockets inside out. By the time he finds them – how the hell did they even end up in his hospital sneakers – all the others have already gone. Some of the students suggested going to the Shamrock Irish pub, but Jacob didn't feel like it. He smells of hospital and he is still not used enough to the scent to ignore it. He just wants a shower, curl up on his couch and watch bad TV. 

Pediatrics and neonatology are almost deserted this time of night. There are a man and a woman in one of the NICUs, staring down into a plastic incubator, looking tired and lost and Jacob hurries down the hallway not wanting to get involved with anyone or anything. 

It is the cough that makes him stop in the hallway. It sounds dry and heaving, strangely wet at the same time. Imagine a cable being connected to someone's chest, plugged in through the ribcage and that cable connected to a stack of amplifiers, letting the cough rip through the Grand Canyon for added effect. That's how it sounded. Another cough and Jacob, against all better judgment, turns around and walks towards the door.

He pushes the handle down slowly, opening the door as quietly as he could, which is silly, he knows. Anyone coughing that hard cannot be asleep. The room is dark save for the brilliantly white halogen light of the bedside table and there is a little girl sitting in that cone of light, hunched over, air rattling through her chest as she tries to breathe.

“Are you alright? Can I get you anything?” Jacob asks quietly, but he still startles her.  
She clears her throat, the sound making his flesh crawl. The debris and junk of a body that's given up already dragging through those tiny lungs.  
When she looks up at him, it's like staring at a ghost. Her skin so pale and sickly looking, it almost seemed translucent, dark rings framing those horribly hollow eyes.  
She shakes her head. 

“Okay, try to get some sleep then,” Jacob whispers, smiling at her.

He has almost closed the door when she calls out to him.  
“Wait! Can you...will you read to me? Her voice is soft bones being dragged over a grater. She looks at him pleadingly.  
“Just to help me fall asleep?”

He nods, knowing if he doesn't do this, he won't be able to go to sleep tonight, knowing that pleading look will haunt him.  
“What would you like me to read,” Jacob asks, as he's standing at her bedside and sees the piles of books. There are some Dr Seuss, a Harry Potter, some other ones he doesn't recognize. Out of the folds of her bed, she pulls a frayed and yellowed hardcover, the book's jacket already torn in places. When she holds it out to him the book trembles.

“Alice in Wonderland. The Mad Tea Party.” She smiles at him through gapped teeth. 

He pulls the chair closer to her bed and settles in, opening the book on chapter seven, the pages falling open willingly there, they have been read so many times already.

“There was a table set out under a tree in front of the house, and the March Hare and the Hatter were having tea at it: a Dormouse was sitting between them, fast asleep, and the other two were using it as a cushion, resting their elbows on it, and talking over its head.” Jacob reads out loud, pausing slightly, before continuing in a higher, thinner voice, "Very uncomfortable for the Dormouse," thought Alice; "only, as it's asleep, I suppose it doesn't mind." She smiles at him tiredly and Jacob winks before he continues.

“The table was a large one, but the three were all crowded together at one corner of it: "No room! No room!" He screeches, “when they saw Alice coming. "But there's plenty of room!" Jacob whines indignantly in his Alice voice. “And she sat down in a large arm-chair at one end of the table.”

"Have some wine," he offers, giving the March Hare a strangely nasal voice, taking his eyes off the book just for a moment to look at the girl.  
She smiles at him with closed eyes, an almost serene expression on her face.

“I'm not asleep yet,” she rasps and so Jacob continues.

It is well past midnight when he closes the book quietly. She hasn't stirred in the last fifteen minutes or so and he has stopped reading some time ago. She is wearing Hello Kitty pajamas – faded cats chasing pink and yellow balloons across a field of cotton sprayed with drops of blood from the coughing.  
Carefully, he lays the book back on the bedside table and reaches towards the foot of the bed to retrieve the chart. Anna Martinez. Diagnosis: ALL.

He comes back the following night after shift ends. He found his keys alright but still dawdled enough to make the others leave without him. On his way to pediatrics he makes a detour through the cafeteria, snagging three pudding cups, one vanilla, one chocolate, one strawberry and two spoons. 

They eat in companionable silence, Anna polishing off the chocolate and half of the strawberry one, while Jacob slowly eats the cloyingly sweet vanilla cup.  
She has a cat at home, his name is Omlette, he is fat and orange and she misses him terribly. Omlette once brought home a mouse that was still alive and her mum shrieked so loud when she found out and climbed on the kitchen chair, yelling for her dad while Omlette chased the squeaking mouse through the kitchen.  
She laughs, then coughs and scratches her head. There are bruises on her arms from all the IV injections. Hopeless cases don't get central lines. Nobody cares about track marks when the kid is laid out in a pretty, long-sleeved dress and nicely done hair at its own funeral.  
She started to take horse riding lessons but she got too sick to get any good at it. She smiles at him and suddenly Jacob finds it hard to say anything. He remembers the low blood count in her folder. Five days tops.

He reads to her again. Harry Potter and the Philosopher's Stone this time. She likes the first books better than the later ones. She doesn't like how lovey-dovey everyone gets. Boys are yuck. You're cute though and she sticks her tongue out at him. There are petechiae on her tongue and gums. All those little blood vessels already hemorrhaging. Stupid bloody fireworks in anticipation for the grand finale. 

She coughs so badly he has to stop reading in the middle of the second chapter. He sits on her bed, rubbing his hand up and down her back. Her ribs stick out and there are bruises on her neck. Weight loss and/or loss of appetite, as well as excessive and unexplained bruising are a common symptoms of ALL, his mind rattles off.  


This is different than in the books though. A case doesn't smell like baby shampoo and it doesn't clutch a floppy bunny to its chests while trying to breathe. A case doesn't sniffle when you hand it a tissue to spit the blood and mucus into. It doesn't lean back in its bed, closes its eyes and pretends everything is alright while shamefully wiping at the tears webbing between long children's lashes.

He tucks her in before he leaves, carefully placing the pale blue bunny in her arms. Her hands are ice cold but he can see the sweat beading on her forehead.

When he comes back the next night she is gone. The bed is empty and the books have all been taken away.  
He sweet talks one of the elderly nurses into letting him look at her file before he goes home.  
TOD: 4:36 pm.  
COD: HF. Heart failure.

That night he lies in bed, staring up at the water stained ceiling of his shitty apartment. Every breath he takes is a reminder that Anna stopped breathing today at 4:36 pm. Ten years old and already that body, which had been designed to last her decades had given up on her, abandoned ship. Just like that. 

When he closes his eyes, he can imagine what it would look like inside that little hollow shell just minutes before she left. All through her body, light shining through down into the veins and arteries through the thin skin there are her white blood cells, mutating, replicating, swirling through the highways and byways of her body so fast nothing can stop them. They hook their barbs into her bone marrow, spreading and setting up shop, letting every intruder pass them by, not knowing what they're supposed to do and it all gets in and there's nothing there to stop it. 

He imagines it like an oil slick, creeping through the intricate spider web of arteries and capillaries, coating everything it comes into contact with with its fat shining black ooze, clogging up and shutting down as it progresses. It spills over the blood-brain barrier, those fine branchings webbing her brain turning black as it spreads, gnawing in deeper and deeper until it reaches that one, most vulnerable point. 

The heart starts to stutter, not knowing what to do with these impulses that come more falteringly now, it's getting confused by these mixed signals. As the temperature goes up and the heart beats more and more erratically, what remains of that body wants to gear up for one last fight but it can't. Wherever it reaches, there's black goo, slowly smothering vital functions, that little heart's beat becoming fainter and fainter until the back waters crash over it. And then there's nothing. Radio silence.

There's still some oxygen left for her brain, up to six minutes worth of it and Jacob imagines all those memories fading away, like someone slowly erasing the world's most complicated hard drive while the oxygen slowly runs out. It could be a bird's eye view of a big city at night, illuminated by a thousand lights but now they slowly start to go out.

The periphery is first. Flickering, once, twice and then it's gone, off the map as the lights go out. Maybe those lights were this is how you breathe, this is how you move your muscles, this is how you smile. On the other end the lights slowly die down, turning from bright yellow to dull white, to black. This is how your heart is supposed to work. 

It's closing in on the remaining lights, the world down there getting darker with every passing moment. Lights crackle and pop, like a thousand light bulbs getting fried at the same time. This was your last birthday, your first riding lesson. This is how a horse smells and this is what it feels like when you pet it. Crackle and pop. This is every book you ever loved and all those stories. The world gets a little dimmer with every window that goes dark. This is how strawberries taste and this is how Omlette's fur smelled. One by one they go, the oxygen slowly running out.  
Four minutes. Five. Six.

There are only two lights remaining, glowing so faintly now in that overwhelming darkness. These are your mum and dad and they love you more than you will ever know. The window goes dark.  
  
This is you.  
And then that last light flickers and dies.


End file.
